Dietetics
Acute Medical
The acute nutrition and dietetic team are based at the Royal United Hospital and work across all the wards (adult and paediatric). The acute team also offer outpatient service to adults and paediatrics.
Critical care
If patients experience a life-threatening illness or injury, their nutritional needs will change. The critical care dietitian will make sure they get the right amount of nutrition, at the right time and in the right way, to support recovery. They can also advise patients on eating and drinking well after they leave intensive care.
Critical care dietitians can help anyone with a life-threatening illness or injury. This includes children, adults and older people and work with a team of skilled staff supporting patients on the intensive care unit.
Critical care dietitians work with consultants, nurses and other health professionals to optimise patient’s nutritional care. When patients are extremely unwell, the nutritional needs may change on a daily basis. Critical care dietitians are specially trained to adapt the nutrition plan quickly if condition changes. If patients are unable to eat and drink, the dietitian will help patients get the nutrition they need through a tube - either into the gut or straight into the blood supply. Once patients are able to eat and drink again they may have ongoing problems with reduced appetite, taste changes or swallowing difficulties. The dietitian can advise patients on how to get the nutrition they need.
Gastroenterology
Gastroenterology dietitians help patients to eat the right food if they have a digestive disorder. They also help them get enough nutrients to help avoid unwanted weight loss and malnutrition. They are specialists in the dietary management of condition that affects the stomach, liver, pancreas, small intestine or colon, for example, Crohn’s Disease, Liver Disease, Pancreatitis or Coeliac Disease. These conditions can stop the body absorbing food properly and cause uncomfortable symptoms and unwanted weight loss. The ward medical team will monitor the patients food intake if they are concerned that they are not managing to eat enough or are concerned that they are losing weight and then will refer to a dietitian for an assessment and support.
Oncology and Macmillan
The Macmillan Dietitian is based at the Royal United Hospital and works mainly in outpatients, reviewing those undergoing cancer treatment for oesophageal, stomach, and head and neck cancers. The dietitian also offers an inpatient services to those patients.
Rheumatology
Dietetic advice is provided to patients receiving care through the Royal National Hospital for Rheumatic Diseases (RNHRD). This may be through a one-to-one appointment with a dietitian or through a group session organised by the RNHRD. The types of conditions we most often encounter are Scleroderma, Lupus, Sjogren’s Syndrome and Fibromyalgia. However patients may be referred to a dietitian in connection to another condition. We see patients for a variety of reasons including swallowing problems, unplanned weight loss, wanting to lose weight, food intolerances and irritable bowel syndrome.
Specialist Weight Management Service
A specialist dietitian works with the Consultant endocrinologist to provide a specialist weight management service (Tier 3). Patients must be referred by the GP via the individual funding request (IFR). The service provides weight management support and interventions for a 6-12-month period. The service also supports appropriate individuals to prepare for bariatric (weight loss) surgery which takes place at Southmead Hospital, Bristol. Patients must have intensive support from a specialist weight management service before they can be considered for referral for weight loss surgery. This is based on national guidance.
The aim is to help patients lose at least 5% of their weight and improve health and emotional wellbeing. The patient will be initially seen (at the first appointment) by the consultant endocrinologist and the specialist dietitian, at the Royal United Hospital. The dietitian will continue to see the patients in individual monthly appointments to offer advice and support to help monitor motivation and changes to diet and lifestyle. These appointments may be at the Royal United Hospital or at St Martin’s Hospital. The dietitian will discuss the patient’s dietary patterns and help identify ways to make sustainable changes. This may include advice about meal planning, appropriate food choices, portion control, managing hunger and avoidance of 'yo-yo dieting'. Exercise is also encouraged. The patient will also need to have a psychology assessment which will be organised.
In addition to the individual appointments, the specialist dietitian also runs a weight loss surgery support group in Bath (BWLSS). Patients are encouraged to attend the group if they are thinking about pursuing weight loss surgery or have had weight loss surgery and want further information and support. These groups are run every two months on the last Wednesday evening of the month. For further details please contact Cheryl.richards@nhs.net
The Specialist Weight Management Service also supports patients who have had weight loss surgery for a period of more than two years and need further advice and support (Tier 5).